The overall objective of this proposed program is the commercialization of the Pediatric Impella system, a minimally invasive ventricular assist device (VAD) for treatment of acute heart failure in pediatric patients. The device will be a less traumatic alternative to extracorporeal membrane oxygenation (ECMO), the current standard of care for these patients. The target patient population is in the age and weight range of 3 mos - 3 yrs and 5-15 kg. The Pediatric Impella system will be designed to unload the left ventricle and promote cardiac recovery, providing blood flow in the range of 0.5-2 lpm for up to 2 wks of support. Reviewers pointed out in discussion that the device is not as minimally invasive as claimed and will require more anticoagulation than is suggested in the application. Since there are only a few devices in the field for this problem, this proposal addresses a great unmet clinical need and has high significance.